Research On Health Resource Allocation Based On The Principle Of Equity

Chongqing is the only metropolitan city in the central and western China, as a pilot area of urban-rural comprehensive development reform, Chongqing is of important strategic position in promoting regional coordinated development and reform & openness. Chongqing is a big city which implemented strategy of city advancing rural, its special geographical environment and historical conditions between urban and rural caused socioeconomic differences between urban and rural or among regions. Meanwhile, health resources allocation and residents’health status also present the differences among regions.Under the background of the development of an integrated planning of urban and rural reform, deepen reform of the medical and health system. This study describes present situation of health resource allocation, total amount of health resources; analyze the balance of health resources supply and demand; study the equity and efficiency of health resource allocation; predict the total amount of health resources in 2020 and make the health resource allocation standard. Our aim was to promote the equity of urban and rural health resources allocation, build health service system which could meet the urban and rural residents’basic medical demand, so as to improve residents’health.Objective:(1) To analyze present situation of health resource allocation, total amount and structure of health resources;(2) To analyze the balance of health resources supply and demand;(3) To study the equity and efficiency of health resource allocation;(4) To predict the total amount of health resources in 2020.Methods:Excel2010, SAS9.2, SPSS18.0, GM3.0 were applied in this research. Descriptive analysis, supply and demand balance method, grey correlation analysis, RSR, improved demand method were used in process of data analysis.Results:(1) Historical development and the status quo of health resource allocation in ChongqingRecent years, medical and health service in Chongqing grew rapidly, cut off 2013, there were 147436 beds, annual rate of growth is 8.7%,4.39 per T000 population; By the end of 2013, there were 55221doctors,3231 increase from the previous year, the annual growth rate is 4.2%; there were 55417 nurses,5594 increase from the previous year, the annual growth rate is 10.6%. Although the total amount of health resources in Chongqing from 2004 to 2013 are on the rise, the number of health resources per thousand populations was only higher than Yunnan and Guizhou provinces.(2) Balance of health resource supply and demand in ChongqingAnalyze the balance of health resources supply and demand. The ration of beds supply and demand is 1.079, which in the range of 95% to 105%, that is the supply and demand of beds is balance in Chongqing; the ratio of doctors is 0.968, which also could be seen as supply and demand balance; the ratio of nurses is 0.648, which is below the supply critical value 85%, could be seen as unbalanced.(3)Equity and efficiency evaluation of health resources allocation in Chongqing38 regions were divided into 4 parts according to relative demand and supply of health resource, that is, both supply and demand are high (Yuzhong、Nanan、Jiangbei etc.); Both supply and demand are low (Xiushan、Youyang etc.); Relative demand is high but supply is low (Qijiang、Changshou etc.); Relative demand is low but supply is high (Dadukou、Yunyang etc.).38 regions were divided into five classes according to health resources utilization efficiency. The first class (Yuzhong、Nanan etc.); The second class (Tongnan、Hechuan etc.); The third class (Dazu、Wanzhou etc.); The fourth class (Yongchuan、Qianjiang etc); The fifth class (Jiangjin、Qijiang etc.).(4)Make the health resource allocation standardThrough improved demand method calculating health resource allocation standard, in 2020, total amount of beds are 186206, upper and lower limited lines are194503,177909 respectively; Doctors are 267125, upper and lower limited lines are 277702,256549respectively; Nurses are 400688, upper and lower limited lines are 416553,384823 respectively.Conclusions:The health resources from 2004 to 2013 have increased year by year in Chongqing, but per capita were still at the low level. Government sponsored health resources are dominant, the principle of "equity priority, efficiency must be given consideration" is more needed to optimize resource allocation; nurses are mainly centralized in hospitals but lack in basic medical institutions; there were big differences between each functional districts. In 2013, the supply and demand of beds and doctors are balance in Chongqing; the ratio of nurses could be seen as evenly balanced, but which close to the supply critical value, which means the lack of nurses in Chongqing. There are still a lot of districts in a condition of relative high demand but low supply or vice versa, health resource allocation in Chongqing is inequitable. The total utilization efficiency is turning good, but the differences among regions are shown significantly, there were both excessive and insufficient utilization of health resource.